Tracheostomy in children with bronchopulmonary dysplasia: frequency, clinical features, comorbidity and outcomes

Some patients with bronchopulmonary dysplasia (BPD) whose status requires long-term mechanical ventilation (MV), undergo tracheostomy (TS), however, the characteristics of such patients are not presented in domestic studies as yet. The purpose of this research was to calculate the frequency of TS in children with BPD, to assess the clinical features of such patients’ status, the comorbidity and the outcomes in these patients. Materials and methods used: 73 children in their first year of life - aged 2.0 [1.0; 5.0] months old, 45 (62%) boys/28 (38%) girls, with diagnosed BPD participated in a single-center cohort retrospective study and were divided into two groups (with BPD and TS; 14, and with BPD but without TS; 59), who were admitted at the Morozov Children’s City Clinical Hospital (Moscow, Russia) in 2020-2023. The demographic characteristics of patients, their comorbidity and mortality as well as the reasons for TS were assessed. Results: the frequency of TS in infants with BPD was 4.3% [95% CI 2.4%; 7.2%]. In the structure of infant patients with TS, children with BPD accounted for 18.7% [95% CI 10.6%; 29.3%]. In 14 children with BPD, TS was performed at median age of 3.5 [2.0; 6.0] months old with an average age of 4.4±2.7 months old. These patients had severe comorbidities, such as: perinatal CNS damage (all of them), congenital heart defects (6), Edwards syndrome (2), Down syndrome (2) and CHARGE syndrome (2). Patients with BPD and TS, compared with patients with BPD but without TS, had statistically significantly greater gestational age (p=0.005) and birth weight (p=0.046), rather frequently needed the MV (p=0.007) and ware assigned with the palliative patient status (p<0.001). Of the 8 children with BPD with TS with known follow-up, 5 (63%) had died. Conclusion: the need for TS and long-term MV in children with BPD is determined by severe comorbidity.